Blue Rubber Bleb Nevus Syndrome: Small-Bowel Lesions Diagnosed by Capsule Endoscopy

Figure 1 A 57-year-old woman was admitted to hospital due to chronic iron-deficiency anemia (< 10 g%). She denied having observed any overt gastrointestinal bleeding; her hemoglobin level at admission was 6.4 g%. There were multiple hemangiomas on her back and limbs, in her mouth, and underneath and on top of the tongue. Abdominal computed tomography showed a number of various-sized lesions in the liver. An isotope-marked red blood cell scan showed a concentration of lesions in the liver and mediastinum. Colonoscopy was normal. Esophagogastroduodenoscopy revealed two vascular lesions on the greater curvature of the stomach, with no active bleeding.

Figure 2 It was therefore decided to carry out a capsule endoscopy, which revealed a number of various-sized vascular lesions in the jejunum. The largest lesion was 2 cm in diameter, without any active bleeding.